Wang Rui, Zhang Yuping, Zeng Huiqian, Xiao Jinyan, Qi Mingming, Bao Lei, Jiao Ruifen, Liu Jing, Li Yichun, He Shuli, Li Yunlong, Li Rui, Ping Fan, Liu Yanping
Clinical Nutrition Department, Peking Union Medical College Hospital, Beijing, China.
Obstetrical Department, Guangzhou Women and Children's Medical Center, Guangzhou, China.
J Diabetes Res. 2025 Jul 14;2025:1021066. doi: 10.1155/jdr/1021066. eCollection 2025.
This study was aimed at analyzing the impact of blood glucose variability (GV) in gestational diabetes mellitus (GDM) patients on glucose outcomes 42 days postpartum and pregnancy outcomes. Additionally, it explored differences between various GV indices and evaluated their predictive values. This retrospective study included 75 pregnant women diagnosed with GDM. Continuous glucose monitoring (CGM) was initiated postdiagnosis, and outcomes were followed up. Oral glucose tolerance tests (OGTTs) were conducted 42 days postpartum to assess glucose response. A total of 75 patients were included, among whom 8 (10.67%) exhibited impaired fasting glucose (IFG) and 7 (9.33%) impaired glucose tolerance (IGT) in the 42-day postpartum OGTT. No cases of diabetes were diagnosed. The results of the postpartum OGTT were significantly correlated with various GV indexes. In multivariate analysis, LBGI (OR: 1.437; 95% CI: 1.015-2.035; = 0.041), value (OR: 1.215; 95% CI: 1.030-1.434; = 0.021), and TBR% (OR: 1.138; 95% CI: 1.020-1.271; = 0.021) independently influenced IFG. Receiver operating characteristic (ROC) analysis indicated areas under the curve (AUCs) of 0.877 (95% CI: 0.7600.994), 0.853 (95% CI: 0.7300.975), 0.869 (95% CI: 0.7480.991), and 0.793 (95% CI: 0.6220.963) of IFG prediction model performance of TBR%, LBGI, value, and HbA1c% combined with age, BMI, and family history of diabetes, respectively. Blood GV is an independent factor influencing IFG 42 days postpartum in GDM women, especially with hypoglycemia. It can increase the predictive efficiency of the postpartum abnormal blood glucose prediction model. Chinese Clinical Trial Registry number: ChiCTR2100054833.
本研究旨在分析妊娠期糖尿病(GDM)患者的血糖变异性(GV)对产后42天血糖结局及妊娠结局的影响。此外,还探讨了不同GV指标之间的差异并评估其预测价值。这项回顾性研究纳入了75例诊断为GDM的孕妇。确诊后开始进行持续葡萄糖监测(CGM),并对结局进行随访。产后42天进行口服葡萄糖耐量试验(OGTT)以评估血糖反应。共纳入75例患者,其中8例(10.67%)在产后42天的OGTT中表现为空腹血糖受损(IFG),7例(9.33%)表现为糖耐量受损(IGT)。未诊断出糖尿病病例。产后OGTT结果与各种GV指标显著相关。多因素分析中,低血糖血糖指数(LBGI)(OR:1.437;95%CI:1.015 - 2.035;P = 0.041)、血糖波动幅度(M值)(OR:1.215;95%CI:1.030 - 1.434;P = 0.021)和血糖波动贡献率(TBR%)(OR:1.138;95%CI:1.020 - 1.271;P = 0.021)独立影响IFG。受试者工作特征(ROC)分析表明,TBR%、LBGI、M值和糖化血红蛋白(HbA1c)%联合年龄、体重指数(BMI)及糖尿病家族史预测IFG模型的曲线下面积(AUC)分别为0.877(95%CI:0.760~0.994)、0.853(95%CI: